RESUMEN
Nonalcoholic Fatty Liver Disease (NAFLD) is a common cause of chronic liver disease in childhood and strongly associated with obesity. Routine biochemical non-invasive tests remain with low accuracy for diagnosis of NAFLD. We performed a cross-sectional study to examine potential associations between anthropometric and biochemical parameters, specially TGF-ß, a prognosis marker for hepatic steatosis (HS). Between May and October 2019, seventy-two overweight adolescents were enrolled, of which 36 had hepatic steatosis. Hepatic, lipidic and glycemic profiles, and levels of vitamin D, ferritin and TGF-ß were analyzed. Hierarchical cluster and a discriminant model using canonical correlations were employed to depict the overall expression profile of biochemical markers and the biochemical degree of perturbation. Median values of alanine aminotransferase (ALT), gamma glutamyl transpeptidase (GGT), and TGF-ß were higher in the adolescents with HS. Values of body mass index (BMI)/age and ALT, but not of TGF-ß, were gradually increased proportionally to augmentation of steatosis severity. In a multivariate analysis, TGF-ß plasma concentrations were associated with occurrence of hepatic steatosis independent of other covariates. Discriminant analysis confirmed that TGF-ß concentrations can identify HS cases. Our data reveal that HS patients exhibit a distinct biosignature of biochemical parameters and imply TGF-ß as an important biomarker to evaluate risk of steatosis development.
Asunto(s)
Hígado Graso/diagnóstico , Obesidad Infantil/complicaciones , Factor de Crecimiento Transformador beta/sangre , Adolescente , Alanina Transaminasa/sangre , Biomarcadores/sangre , Niño , Estudios Transversales , Hígado Graso/etiología , Femenino , Humanos , Masculino , Riesgo , Índice de Severidad de la Enfermedad , gamma-Glutamiltransferasa/sangreRESUMEN
In the few cases of acute childhood diarrhea that require antimicrobial therapy, the correct choice of the drug depends on detailed previous knowledge of local strains. In order to establish such parameters in our city, we reviewed the results of all 260 positive stool cultures of children between 0 and 15 years of age during two years at a pediatric tertiary care facility in Salvador, Brazil. Bacterial strains had been presumptively identified by culturing in selective media and by biochemical testing, and their antimicrobial susceptibility patterns were automatically detected by the MicroScan Walkaway System. Data about patients' sex and age, monthly distribution of the cases, pathogens isolated and their antimicrobial resistance patterns were recorded. Males corresponded to 55.4% of our sample, and most of our patients (42.7%) were between one and four years of age. Shigella was the commonest pathogen, being found in 141 (54.3%) cultures, while Salmonella was found in 100 (38.4%) cultures and Enteropathogenic E. coli in 19 (7.3%). Salmonella was the main causal agent of diarrhea in children younger than five years old, whereas Shigella was the most frequent pathogen isolated from the stools of children between five and 15 years old. The peaks of incidence correspond to the periods of school vacations. Shigella specimens presented a very high resistance rate to trimethoprim-sulfamethoxazole (90.1%) and to ampicillin (22.0%), while Salmonella presented very low resistance rates to all drugs tested. These data are useful for practitioners and they reinforce the need for continuous microbiological surveillance.
Asunto(s)
Antibacterianos/farmacología , Diarrea/microbiología , Heces/microbiología , Bacterias Gramnegativas/aislamiento & purificación , Enfermedad Aguda , Adolescente , Distribución por Edad , Brasil/epidemiología , Niño , Preescolar , Diarrea/epidemiología , Farmacorresistencia Microbiana , Escherichia coli/efectos de los fármacos , Femenino , Bacterias Gramnegativas/efectos de los fármacos , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Pruebas de Sensibilidad Microbiana , Salmonella/efectos de los fármacos , Estaciones del Año , Shigella/efectos de los fármacosRESUMEN
In the few cases of acute childhood diarrhea that require antimicrobial therapy, the correct choice of the drug depends on detailed previous knowledge of local strains. In order to establish such parameters in our city, we reviewed the results of all 260 positive stool cultures of children between 0 and 15 years of age during two years at a pediatric tertiary care facility in Salvador, Brazil. Bacterial strains had been presumptively identified by culturing in selective media and by biochemical testing, and their antimicrobial susceptibility patterns were automatically detected by the MicroScan Walkaway System. Data about patients' sex and age, monthly distribution of the cases, pathogens isolated and their antimicrobial resistance patterns were recorded. Males corresponded to 55.4 percent of our sample, and most of our patients (42.7 percent) were between one and four years of age. Shigella was the commonest pathogen, being found in 141 (54.3 percent) cultures, while Salmonella was found in 100 (38.4 percent) cultures and Enteropathogenic E. coli in 19 (7.3 percent). Salmonella was the main causal agent of diarrhea in children younger than five years old, whereas Shigella was the most frequent pathogen isolated from the stools of children between five and 15 years old. The peaks of incidence correspond to the periods of school vacations. Shigella specimens presented a very high resistance rate to trimethoprim-sulfamethoxazole (90.1 percent) and to ampicillin (22.0 percent), while Salmonella presented very low resistance rates to all drugs tested. These data are useful for practitioners and they reinforce the need for continuous microbiological surveillance.